Laser urinary incontinence treatment
Currently, about 40% of all women suffer from urinary incontinence. By classification definitions and terminology, stress urinary incontinence (SUI) – this is 
involuntary loss of urine with effort, sneezing and coughing. The causes of this disease, as a rule, are the most diverse, but in their essence lies the degradation and weakening of the muscles of the pelvic floor. Currently, various, including conservative methods of treating SUI – such as exercises for the muscles of the pelvic floor, taking pharmacological drugs, electrical stimulation, surgical treatment. The most radical of the above methods is surgery based on the use of mid urethral slings, which are used when conventional treatment measures do not improve symptoms. However, in recent years, this surgery has been actively criticized, as there is a high risk of complications, such as impaired urination, early and late pain, including due to damage to the walls of the bladder, tissue erosion, etc. A number of well-known organizations, including the FDA and large medical centers, published articles on surgical methods for treating SUI syndrome and provided additional recommendations and warnings on the use of these methods. The most common cause of urinary incontinence is dysfunction and impaired tissue structure of the pelvic floor, due to the loss of muscle elasticity. The mechanical stability of the neck of the bladder is characterized mainly by the properties of the muscles and tissues of the pelvic floor, so the main efforts of existing methods are aimed specifically at strengthening the mechanical structure.
Laser incontinence treatment
The most promising in recent years are laser therapy techniques for SUI syndrome, which are officially approved by many organizations. The evidence of the effectiveness of this technique is the research and tests that confirm the processes of neocollagenesis that occur in the tissues of the pelvic floor and thus support its structure. Moreover, the main methods of laser treatment of stress urinary incontinence have two directions. The first direction uses laser radiation without ablation and the methods that are used in it use photothermal effects to reduce collagen fibers without denaturing tissue. For this, a controlled heating of tissues to a temperature of 65-70 degrees is performed. due to laser radiation. The photothermal effect of medical laser radiation in this case leads to stratification of the transverse bonds of intermolecular compounds, which leads to the ordering and structuring of three-helical collagen fibers, and, accordingly, to tissue densification. These processes occur over time and have periods or phases that are important to consider when using this type of technique. During the procedure itself, there is an instant reduction in collagen fibers about 25-30%.
After the first procedure, as a rule, a short-term tissue edema is observed (several days), and then new collagen fibers grow, which lasts up to a year or more, after which, as a result of natural processes, a decrease in tissue tone with reverse degradation occurs. For this direction, non-ablative lasers are the most promising, having a low depth of laser radiation penetration into tissues, having wavelengths in the range of 1.3-1.6 μm or radiation of an erbium laser (2.94 μm) in a non-ablative mode (in this case, heat transfer is carried out exclusively in result of heat diffusion). The second therapeutic area of laser treatment of stress urinary incontinence is the use of ablative pixel (fractional) techniques that trigger neocollagenesis due to microdamage of the mucous membrane with a certain frequency and size of regeneration points. This technique is based on thermal tissue damage that induces inflammation and subsequent repair with regenerative functions. This fractional microablation laser therapy leads to an intense reaction of skin fibroblasts, which leads to the formation of large diameter epithelial cells in a short time (4-6 weeks) and the formation of ordered collagen fibers capable of supporting the pelvic floor muscles.